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Reducing the risk of Frey’s syndrome after parotidectomy – which methods are best?

Gustatory sweating or Frey’s syndrome is a well-recognised complication of parotid surgery. The reported incidence is highly variable, from 4% to 96%, with around 30% of patients reporting symptoms. A number of intraoperative techniques can be used to reduce the...

Food impaction in children is associated with eosinophilic oesophagitis

There is an increasing amount of evidence to suggest that chronic oesophageal inflammation and motility disorders play a more significant role in oesophageal food impaction (EFI) in children compared to structural defects. The authors conducted a retrospective study of children...

To drain or not to drain

These two separate papers neatly tie together the same ideas. The first, a retrospective study of 107 patients and 116 procedures over a 10-year period who underwent a CSF leak repair, 82.2% without a lumbar drain and 17.8% with. The...

Incidental thyroid nodules: should we observe or operate?

Thyroid nodules are extraordinarily prevalent, detected by physical examination in 7% and by imaging studies in 67% of the population. Although most of these nodules are benign, up to 20% are found to be malignant on excision. It’s a very...

Treatment algorithm for olfactory disorders

The purpose of this paper is to review the current evidence in diagnosing olfactory disorders and suggest an algorithmic approach to patients with relevant complaints. Age-associated olfactory loss is often multifactorial and requires a careful history and physical exam. A...

The septum and breathing

The authors compared the improvement in nasal obstructive symptoms in two groups of patients. One group underwent septoplasty alone and the other septoplasty accompanied with compensatory turbinoplasty. They used the Nasal Obstruction Symptom Evaluation (NOSE) [12] and visual analog scale...

A novel way to reduce postoperative nausea and vomiting

This is an interesting RCT which evaluates the prophylactic effect of bilateral endoscopic injection of local anaesthetic in the sphenopalatine ganglion (SPG) on postoperative nausea and vomiting (PONV). It has a robust design, and is sufficiently powered and blinded, with...

Delirium post-op

This is a retrospective study from Japan analysing 102 patients who underwent oral cancer resection and free flap reconstruction. Postoperative delirium occurred in a third of these patients. An increased risk was identified in those with high preoperative albumin, postoperative...

Do nasal septal deviation and septoplasy affect Eustachian tube function?

The authors suggest that nasal septal deviation (NSD) or septoplasty possibly affect Eustachian tube (ET) function. They conclude this from their prospective study on 25 patients who underwent septoplasty for NSD. These patients aged above 14 years had no other...

Reduce medical errors by improving communication: supporting vulnerable people

This article starts by emphasising that communication failures are a fairly common cause of medical errors. They highlight that people with dysarthria can experience significant communication difficulties and are at particular risk of this type of breakdown in care. People...

Comparison of outcomes after septoplasty

For this prospective study, the authors assessed the quality of life (QoL) with the rhinosinusitis SNOT-20 (Sino-Nasal Outcome Test-20) questionnaire and the symptoms on a visual analogue scale (VAS) in all patients undergoing nasal septal surgery. The patients reported the...

A move away from bony free flaps in reconstruction

Techniques for facial reconstruction have come on in leaps and bounds since the world wars. The use of titanium implants is more recent and the technology for manipulating the metal and how we use it is rapidly developing. Here the...